Provider Demographics
NPI:1467100867
Name:K E RIVARD COUNSELING LLC
Entity Type:Organization
Organization Name:K E RIVARD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIVARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:734-777-3830
Mailing Address - Street 1:15479 S TELEGRAPH RD STE B
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-8001
Mailing Address - Country:US
Mailing Address - Phone:734-777-3830
Mailing Address - Fax:
Practice Address - Street 1:15479 S TELEGRAPH RD STE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-8001
Practice Address - Country:US
Practice Address - Phone:734-777-3830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty